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Medicare Patients Now Can Do a Check-Up on Doctors

In a major data release this morning, Medicare shared information on $77 billion in payments to more than 880,000 health care providers.


Consumers for the first time can look up doctors, find out the number of procedures they have performed and how much Medicare paid. This is one piece of the puzzle for determining the overall value of care being delivered. The information, from 2012 Medicare Part B payments, already has generated some eye-popping articles, with reports of one Florida ophthalmologist receiving $20 million from Medicare while a New Jersey pathologist collected $12.6 million for tests.

You can check on how much your doctor received in Medicare payments by using this handy database by the New York Times.

The American Medical Association is unhappy with the disclosure, although consumer advocates say  transparency can help beneficiaries find physicians with experience in the area of care needed.

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"This might be helpful to identify doctors who do a large number of procedures," says Keith Lind, a senior policy advisor for AARP's Public Policy Institute. "It's been well known for some time, 'Practice makes perfect.' "

The reverse of that, he says, is "Lack of practice may be a reason for caution."

For researchers, the data will allow them to compare costs and efficiencies among physicians, Lind says. And that could identify savings, potentially help beneficiaries get better care and improve the program in other ways, he says.

The Obama Administration released this information, saying transparency is good for consumers. It also noted that disclosures could locate fraud in a program with financial problems. The Medicare trust fund, which pays for hospitalization and other institutional care, will start running out of money in 2026, according to a report last year.

The AMA opposed the release of this information. Yesterday, the medical group warned on its website that the information could contain errors, and doesn't gauge the quality of care or allow consumers to clearly compare doctors. And the AMA advised journalists to "verify the data before you publish."

Consumer advocates and researchers say consumers looking at the data need to take some things into account:

"It is true there is no quality measure attached to this information," Lind says. Physicians are just beginning to report this, and this information could be added later, he says.

Cristina Boccuti, a senior associate on Medicare policy for Kaiser Family Foundation, says the information also doesn't show the full scope of a physician's practice.

For instance, the data may show that one physician has done more back surgeries on Medicare beneficiaries than another.

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"You have no idea what they are doing with their other patients," she says. So, it's possible that the second doctor has done just as many, if not more, back surgeries - just not on Medicare beneficiaries, she says.

Also, be aware that a doctor may have a broad mix of patients, including many younger consumers, whose information is not included in the data, she says.

That said, the data can reveal doctors with lots of Medicare patients, which may be important for older consumers who want a physician more familiar with health issues affecting their age group, she says.

Medicare Part B pays 80 percent of the cost of care, and most beneficiaries buy supplemental coverage that picks up the rest, Boccuti says. Even so, consumers might want to check the data if they are curious about the cost of care, she says.

"A lot of people with Medicare do care how much Medicare is paying for them," she says. "They want Medicare dollars to be spent wisely."

Pamela Tainter Causey, a spokeswoman for the National Committee to Preserve Social Security and Medicare, says the government's  data isn't in a user-friendly format. Medicare is expected to provide information later to help consumers understand it.


Photo: nui7711/iStock


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